The most winnable battle in the war against Alzheimer’s disease might be the one being fought to head off amyloid accumulation in the brains of youngish individuals who have neither functional symptoms nor markers on imaging but are at risk due to family history.

It’s a fight involving the collaboration of farsighted researchers, innovative drug developers and, not least, determined study volunteers. You might even call the latter group heroic.

One clinical trial, called A4 for Anti-Amyloid Treatment in Asymptomatic Alzheimer’s, “asks a lot of its participants,” explains science journalist Elie Dolgin in an illuminating feature article published online Feb. 16 in Newsweek. “A4 subjects must be willing to come to a hospital once a month for more than three years to receive infusions containing an unproven medicine for a disease they don’t have and might not get. There’s no guarantee of benefit or even safety.”

There’s not much in the way of monetary incentive, either. Some money is available for some participants who complete all study protocols—which include numerous PET and MRI scans, a couple of spinal taps and dozens of drug infusions—but lots of participants get little more than free parking.

Dolgin writes:

None of that dissuaded Jerry Blackerby from taking part in A4. “With my family history, I have expected to have Alzheimer’s long before death, and I haven’t yet,” says Blackerby, 82, a retired technical writer whose mother died from the disease, as did her three siblings. “If I’m going to have it, I want to be involved in the study to try to keep others, especially my descendants, from having to go through the hell I’ve seen family members go through.”

A4 is one of five major clinical trials that, together, may ring up as much as $1 billion in costs, Dolgin reports.

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